Brief Answer:
Treatment of Blisters with dry STSG- Skin Donor Site

Detailed Answer:
Provisional Suggestion-
Treatment of Blisters with dry STSG(Split Thickness Skin Graft )- Skin Donor Site

Hi,Dear ,Thanks for the query to HCM virtual Clinic.
I studied your query in all the details updated from you along with photographs of the donor skin area.
Your Health concerns as understood from your query are as follows-
You want advise on Emollient cream for Dry and Blistering Donor Site.

Points to be noted in your case (as perceived from the photographs)are as follows-
-There are blisters at some points with scabs with controlled-infection at few spots-indicating that the strength of the epithelised skin is not enough as the Rest and healing conditions required are not enough.

-I am just worried to find that the epithelisation is not strong enough still,even after 42 days and needs to be investigated in your case.

Suggested Remedy plan in your case would be-

Silvadene 1% -medicated cream locally to Replace all other local emolients,as it would take care of infected blisters and would speed up strong epithelisation

Stop using Tubigrip / or Aquaphor and nivea to avoid infection of the blisters due to soddening ,which might be impeding strong epithelisation with other causes.

High Protein Bland Diet (Boiled or fried-2 eggs x 2 times per day x for 3 weeks to begin with)

Vit E 400 mgm 1 capsule per day.

As asked from you above are the suggested the Remedies along with the options for the problematic emollients used by you for the donor site which is quiet dry and blistering at few sites.

You are advised to take this treatment with cover from your treating plastic or General Surgeon.

Hope this reply would resolve your problem to your satisfaction.
Welcome for any further query in this regard to ME.

Update your informative comments (any blood reports)on delayed healing in your case,which would help me to help you out in this problem.

Wishing fast recovery for you.
Have a good day.
Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS

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Brief Answer:
Treatment of Blisters with dry skin Donor site(Split Thickness Skin Graft)

Detailed Answer:
Your Health Concern-
Treatment of Blisters with dry STSG(Split Thickness Skin Graft )- Skin Donor Site

My Diagnosis-Delayed Wound Healing of the STSG donor Site ?due to bacterial infection of the Donor Site

My suggestions on Remedy-Change of the dressing cream with medicated Silvadene Cream and other corrective steps as advised in last and this reply.
........................................................

Hi,Dear thanks for the update query and your photographs.
I reviewed your photographs in reference to your query.
-On reviewing your blister sites,its yellow discoloration is due to the infection of the blister fluid.A normal health scab would have been white,due to collagen healing fibers.
-Overnight open applications would reduce your discomforts of moistening and spoiling of clothes.
Silvadene thin smear application at these areas would take care of the infections of blisters in the donor sites and would not moisten to create any discomforts by clothes spoiling.
Simultaneously this cream would have moistening or emollient effect which would reduce its dryness and would help adequate healing of the donor site.

Cause of these blisters is due to crack wounds due to stretching of the healed wound areas,due to the non-bearing stress and due to inadequate strength in the wound fibers.
Any infection of such wound cracks would be taken care of by Silvadene smear application.
-There is no need of thick layer application of the Silvadene cream,which if required, would need padded surgical sterile dressings to avoid spoiling of the clothes.
If you feel that smear would increase your discomfort, thin surgical padded dressing may be needed,which is not a must as the blister wounds are few and a thin smear is adequate and effective to take care of it.
-You can take help of your treating clinic and doctor in that case,if need be.
Impression and Suggestion for your case-
Attending to the skin dryness and blisters(effects of the root cause factors) needs to be supported by,Treatment of the root cause of these problems-which is Hypo-proteinaemia and anaemia,which needs to be attended with help of your treating doctor

Reasons of Delayed Healing in your case area as follows-
Your skin donor site got blisters mostly due to the infection of the cracks in the healing tissue.This infection in the wound has occurred mostly due to following reasons-
Non-medicated cream applications which did not contain anti-bacterial medicines
and due to the delayed wound healing due to ?anaemia and or?due to hypo proteinaemia, which occurs in burn cases.
Advise for future treatment plan-
-Update Your blood test reports if they are done,to study if these factors are the reasons of this delayed wound healing in your case.
-This is very important area in your wound management of donor site which has missed unattended in your case.
-Iron supplements and Protein supplements would improve the wound healing at the donor site.

Hope this would satisfy your query and would resolve your skin dryness and blister problems.

Welcome for any further query in this regard to ME.I would love to attend to it till its resolved totally to your satisfaction.

If this reply has helped you to your satisfaction,please write excellent review and hit thanks,as this would improve my rating for the new visitors at HCM.

Wishing you fast recovery of this health problem.
Have a good day.
Dr.Savaskar M.N. XXXXXXX Surgical Specialist.
M.S.Genl-CVTS

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Brief Answer:
Delayed Wound Healing of the STSG donor Site ?due to bacterial infection

Detailed Answer:
Final Diagnosis and Suggestions-
1-Delayed Wound Healing of the STSG donor Site ?due to bacterial infection
2-Treatment of Blisters with dry skin Donor site(Split Thickness Skin Graft)

Hi,Dear,thanks for the appreciative remarks from you.
I am happy that at last, you could understand what is going wrong in your case and I hope I have done my efforts to satisfy to your health needs.

I hope you understood the real way out- is not application of Silvadene thin layer cream to blisters, but to treat the root cause of its occurrence,which is
Anaemia (Burn Anemia) and Burn related Hypoprotenemia.

I hope you liked my reply and would hit thanks and write your "excellent review comments on your this consultation-experience" with my services at HCM,which would improve my rating for those needy visiting to HCM.

Wishing you for fast recovery and for your healthy and good life in time to come.

Have a good day

Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS

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